Geographical Disparities in Hypertension Incidence Rate in Iran 2004-2016: Bayesian Spatial Analysis

Roghaye Zare; Erfan Ghasemi; Shirin Djalalinia; Masoud Alimardi; Moein Yoosefi; Abbas Rahimi-Foroushani

doi:10.18502/jbe.v9i3.15445

Roghaye Zare Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Erfan Ghasemi Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Shirin Djalalinia Development of Research and Technology Center, Deputy of Research and Technology Ministry of Health and Medical Education, Tehran, Iran.
Masoud Alimardi Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Moein Yoosefi Department of Mathematics and Statistics, Memorial University of Newfoundland, NL, Canada.
Abbas Rahimi-Foroushani Department of Mathematics and Statistics, Memorial University of Newfoundland, NL, Canada.

DOI: https://doi.org/10.18502/jbe.v9i3.15445

Keywords: Hypertension; Incidence rate; Bayesian spatial analysis.

Abstract

Introduction: Cardiovascular diseases such as coronary heart disease, heart failure, arrhythmia, and cardiomyopathy all include hypertension as a key risk factor. Research has shown that the early detection and treatment of hypertension and its risk factors, as well as public health policies to reduce behavioral risk factors, have led to a gradual reduction in mortality caused by heart disease and stroke in high-income countries in the past three decades. Trends in hypertension incidence have been monitored at the national level in Iran. The aim of this study examine province-level disparities in Hypertension incidence from 2004 to 2016.

Methods: Use the Non-Communicable Diseases Risk-Factors Surveillance in the Islamic Republic of Iran STEPs registry data. to estimate the incidence rate of hypertension for all provinces in 2004, 2006-2009, 2011, and 2016 using a Bayesian spatial model with Markov chain Monte Carlo algorithm in OpenBUGS version 3.2.3 and R version 4.2.2.

Results: The estimated Hypertension incidence rate in total increased from 19.87 per 1000 people (95% credible interval 14.28, 25.48) in 2004 to 193.02 (171.92, 220.48) in 2016. According to the estimates of 2016, we found that the provinces of Markazi, Ardabil, and Semnan had the highest rate of hypertension, and the provinces of Hormozgan, and Sistan-Baluchistan had the lowest rate. Our findings show that Khorasan, North, Alborz, and Semnan have the most significant percentage change in incidence rate from 2004-2016.

Conclusion: To reduce the prevalence of hypertension in Iranian regions, it is crucial to develop regular hypertension screening programs, especially among the elderly